局部抗生素与类固醇治疗慢性性中耳炎
Christopher G Brennan-Jones1,2, Karen Head3, Lee Yee Chong3
1Ear Health, The Kids Research Institute Australia, The University of Western Australia, Perth, Australia.
添加局部类固醇局部抗生素慢性性中耳炎 (CSOM) 显示不确定的有效性. 有证据表明,局部抗生素单独可能比抗生素-类固醇组合更有效地解决耳部排泄.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 慢性性中耳炎 (CSOM) 是一种持久的中耳感染,其特征是耳部泄漏和听力损失.
- 局部抗生素是一种主要治疗方法,通常与类固醇结合,用于对抗微生物感染.
- 这一审查更新了关于CSOM非手术干预的先前发现.
研究的目的:
- 为了评估添加局部类固醇到局部抗生素的疗效,用于治疗慢性性中耳炎 (CSOM).
- 评估对耳部放电分辨率,生活质量和其他相关结果的影响.
主要方法:
- 进行了对多个数据库的系统搜索,寻找随机对照试验 (RCT) 到2022年6月.
- 包括参与者患有慢性耳部泄漏 (持续时间>2周) 接受局部抗生素-类固醇组合治疗的RCT.
- 主要结局包括出院分辨率,生活质量和耳朵疼痛;次要结局包括听力和并发症.
主要成果:
- 包括19项研究 (2044名参与者),评估了13项治疗比较.
- 在局部抗生素-类固醇组合和局部抗生素单独之间没有发现释放分辨率的显著差异 (非常低的确定性证据).
- 低确定性证据表明,局部诺抗生素单独可能比非诺抗生素与类固醇更有效地解决排泄.
结论:
- 将局部类固醇添加到CSOM抗生素的有效性是不确定的,因为证据的确定性低到非常低.
- 没有证据支持抗生素-类固醇组合与单独抗生素相比,在1-2周内改善排泄分辨率.
- 需要进一步的研究来澄清类固醇的作用,并比较不同的抗生素类别,因为报道的危害很少.
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